A COVID-19 ‘breaking point’? Saint Al’s in crisis standards, Idaho hospitals strained
Fully vaccinated people are five times less likely to contract COVID-19 than unvaccinated people, and those vaccinated people who do get breakthrough cases are five-and-a-half times less likely to be hospitalized than those who are unvaccinated, according to Dave Jeppesen, director of the Idaho Department of Health and Welfare.
At a weekly press briefing on Tuesday about the state’s coronavirus surge, Jeppesen re-emphasized the safety of the authorized and approved COVID-19 vaccines, which he said are the best way out of the pandemic and the current hospital crisis.
Since May 15, when teenagers 16 and older joined adults as being eligible for the vaccine, 89.1% of new cases, 90.3% of hospitalizations and 88% of deaths have come in individuals who were not fully vaccinated, according to data from Health and Welfare. Research from the Centers for Disease Control and Prevention has also found that unvaccinated people were 11 times more likely to die last spring and summer than vaccinated individuals were.
The wave of unvaccinated COVID-19 patients battering hospitals and health care workers in Idaho continues to test the limits of caregivers and health systems. In the Treasure Valley, St. Luke’s Health System and Saint Alphonsus Health System are operating under crisis standards of care, which means the hospitals have to decide how to ration resources if necessary.
Kootenai Health in Coeur d’Alene was the first Idaho hospital to go into the crisis standards, after two public health districts in North Idaho were issued the declaration. The statewide designation from Health and Welfare came a week later.
“What we hear every day from the hospitals is that they are almost bartering,” said Christine Hahn, state epidemiologist, at Tuesday’s press conference. “Hey, we’ve got one bed available. Oh, we’ve got two beds over here.”
St. Luke’s, Idaho’s largest provider, triggered the statewide declaration of crisis standards on Sept. 16, when its hospitals became overwhelmed. Saint Al’s followed shortly thereafter, according to Dr. Steven Nemerson, chief clinical officer for the hospital. The system had previously been operating under “contingency” standards, a step below crisis standards, but was forced to implement crisis standards as resources dwindled.
“Due to COVID patient volume added to non-COVID urgent patient care, we have been forced to care for patients in repurposed clinical areas and a non-clinical space (a hospital gym),” Nemerson told the Idaho Statesman in an email. The system has been “using ratios of patients to health care team members exceeding contingency standards of care despite staffing resources received through the state of Idaho and FEMA (the Federal Emergency Management Agency).”
The hospital’s volume of patients has increased “steadily” since July 4, although it has been stable for the past five days, Nemerson said. On Saturday, the hospital system had 152 COVID-19 patients, with 35 in critical care, and a test positivity rate of over 20%.
Despite the strained situation, Saint Al’s has not yet reached a point where a patient has been denied life-saving care in favor of another patient with a better prognosis, which is a possibility in the crisis standards.
“… We are extremely concerned about patients whose less-urgent medical and surgical needs cannot be accommodated at this time,” Nermerson said. “Our physicians and staff in Saint Alphonsus Medical Group remain in contact with these patients and are prepared to move a patient that experiences worsening of their condition promptly to the ‘front of the line’ as needed.”
And if hospitalizations continue to rise, the strain on Saint Al’s could get even worse.
“… Despite employing the largest workforce ever in the 125-year history of Saint Alphonsus Health System,” Nemerson said, “our physicians, providers and staff could reach a breaking point if the surge progresses precipitously.”
Though intensive care unit beds are experiencing the most strain from COVID-19 patients in Idaho, state health officials said that the leaders of hospitals — whom they interact with daily — have little available capacity in general beds as well.
“They appear in those calls to be pretty full,” said Jeppesen, referring to the daily calls he has with state hospital leaders. “It’s pretty tight across the state.”
This story was originally published October 5, 2021 at 5:43 PM.
